INFORMATION REQUIRED FOR EVALUATING OR MARKETING A PRACTICE

  1. Summary of Information (pages following this checklist);
  2. Pension and retirement fund accounting records, as related to employees;
  3. W-2 or Employee Payroll Report;
  4. Year End Financial Statements for the past five (5) years including practice production/collections (by month) and expenses;
  5. Current Year-to-Date Profit and Loss Statements and Balance Sheet;
  6. Schedule C’s from Personal Tax Returns for last five (5) years and any related or appropriate statements; or Corporate Income Tax Returns for last five (5) years and any related or appropriate statements;
  7. Depreciation Schedule from the last Tax Return;
  8. Aging of accounts receivable (30/60/90/over);
  9. Average daily hygiene production for the last five (5) years;
  10. Fee Schedule (most current);
  11. If computerized, include a list of reports received each month orannually;
  12. Copy of Office Lease;
  13. Floor Plan (if available);
  14. Any Lease Agreements on equipment, furniture and fixtures;
  15. List of any existing liens secured by the practice (i.e. bank loan);
  16. Union or P .P .O. contracts;
  17. Copy of any Office Policies (personnel policies);
  18. Copy of cover page of your malpractice insurance policy;
  19. Current resume or Curriculum Vitae; and
  20. Digital pictures of the practice.